Individual provider Active NPI

Edward Nathaniel Wright, L.I.C.S.W

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1154637247
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118364 Issued in MA
Practice address
8 Thorndike St
Beverly, MA 01915-5858
Phone
(978) 290-2421
NPI assigned
Aug 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 118364 MA Primary

Addresses

Primary practice location

8 Thorndike St
Beverly, MA 01915-5858

Mailing address

8 Thorndike St
Beverly, MA 01915-5858
Phone (978) 290-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222001375 MA Practitioner - Clinical Social Worker 6103107594 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8 Thorndike St
Suite 9
Beverly, MA 01915-5858
Phone (978) 778-6133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1154637247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 THORNDIKE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155858",
            "telephone_number": "978-290-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 THORNDIKE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155858",
            "telephone_number": "978-290-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "EDWARD",
        "middle_name": "NATHANIEL",
        "credential": "L.I.C.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.